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Posted 3/18/2011 12:24 PM (GMT 0)
Good morning all. First post.

Had Palladium 103 implant on February 1, 2011. So at just over six weeks, my doctors say my side effects are "to be expected".

Yet on several forums and sources I've read that after seed implant, many guys say they have no side effects at all.

Is there a place I can ask about specific side effects post brachytherapy, and hear from guys who have "been there done that"?

Thanks.
Tom M.
Age 62, PSA 4.8, Gleason 3+3, Stage T1c, 4/12 positive cores at 10-40%.
Palladium 103 implant February 1, 2011.
Posted 3/18/2011 12:57 PM (GMT 0)
Tom, what kind of side effects are you having? At the six week point I was having very frequent urination problems even with Flomax. I was still having a problem sitting on hard seats. My radiologist showed me a chart that I haven't been able to find on the internet but it showed that most urinary side effects peak at six weeks and then improve over the next six weeks. That's almost the exact path mine took. At the six month mark I had some minor bowel problems for about a month. A lot of guys don't have any problems but my radiologist told me everything I was experiencing was normal.
Posted 3/18/2011 1:11 PM (GMT 0)
Hi Tom,

You found the right place. Several members have used the brachytherapy and can relate their side effects. What are you experiencing?

I had brachytherapy, but used the high dose temporary version so I don't have the seeds left in me. Mine was delivered in two doses on December 6 and 13, 2010. Physically the insertion of the radiation is similar to what you did, they just didn't leave seeds in me. I understand the side effects can be similar. I also had external beam IMRT radiation given in 25 daily doses.

My side effects included more urinary and bowel frequency and urgency. For instance, I am usually one bowel movement daily first thing upon waking in the morning. During, and for about 3 weeks following the radiation, I was going more llike three times a day. I had a little more gas, but never any bloody stools or diarehia. I also had to pee more often including at least one trip during the night.

Physically, I felt like I was sitting on a golf ball for several weeks and had to be careful when sitting or I would get a twinge of pain and certailly avoided hard chairs. I was also swollen and bruised in the area, but that subsided over a couple of weeks and caused no problems, just looked wierd. I had the brachytherapy performed in December, so I am now 90 days out and have absolutely no side effects from the procedures.

I hope this helps and I encourage the seeds guys to weigh in.

Best wishes,

Jack
Posted 3/18/2011 1:20 PM (GMT 0)
RayPat and Jack! - thanks very much for the reply. Here's where I am now:

Daytime urination about every 30 minutes, about 50cc. No pain or burning, but very weak stream. I'm on FloMax .4mg twice a day on doctor's prescription.

At night, need to urinate wakes me up about every 2 hours: first attempt is very tight and slow, about 75-100cc. Walk up and down the stairs a couple times, and I get another 75-100cc, and flow is much better. This "slow/better" cycle occurs at midnight, 2am, then 4am. Then back to the 30 minute daytime cycle.

Slight edema of the legs. (The "sock line" shows the swelling.) Never had this before the brachytherapy. Maybe caused by FloMax?

"Tight rubber band" feeling across the abdomen, 24/7. Bowels move about every other day. On the "off" day, abdomen tightness is a bit worse; on the "movement" day, bowels move twice, with very soft (not liquid, but very soft) stool.

A "hot poker in the rectum" feeling, maybe five times a day. I figure this is proctitis. Doctor says this will gradually pass.

Mild fatigue 24/7. I figure this is due to getting up 3x a night.

Other than FloMax, I take no other medications (!). However, about a week before my implant, my GP prescribed Xanax as needed for anxiety, which I now take maybe one .5mg every other day to ease that tight abdomen feeling. All the doctors say this is ok.

Would really appreciate knowing if anyone else has experienced these things after brachytherapy, and how they dealt with them.

I sure hope that now, at six weeks, I'm going to see the side effects decline soon! I'm an active guy, but the frequent urination and abdominal issues are a problem.

Thanks very much.
Tom M.
Posted 3/18/2011 1:50 PM (GMT 0)

NutmegCT said...


Daytime urination about every 30 minutes, about 50cc. No pain or burning, but very weak stream. I'm on FloMax .4mg twice a day on doctor's prescription.

I had similar problem. I wouldn't worry about the weak stream since going every 30 minutes you won't have much in you.

NutmegCT said...
At night, need to urinate wakes me up about every 2 hours: first attempt is very tight and slow, about 75-100cc. Walk up and down the stairs a couple times, and I get another 75-100cc, and flow is much better.

I had the exact same nightime problems. Had to go twice to feel like I was empty.


NutmegCT said...
Bowels move about every other day. On the "off" day, abdomen tightness is a bit worse; on the "movement" day, bowels move twice, with very soft (not liquid, but very soft) stool.

My bowels seemed normal until the six month mark and then went from one to four bowel movements per morning. Pretty much back to one per day now.


NutmegCT said...
Mild fatigue 24/7. I figure this is due to getting up 3x a night.

For the first four months I completely ran out of energy mid afternoon and had to nap.

After peeing so often for so long you'll need to retrain your bladder. I'm still working on that but have gotten where I only wake up once per night. Sounds like you're doing fine but that's just based on what I experienced and we're all different so be sure to let your doctor know what you're dealing with.
Posted 3/18/2011 2:34 PM (GMT 0)
Welcome Nutmeg,

I had Pd 103 implants too. I was on Flomax for about a week afterwards. I'm not sure it made any difference though. I never had any urination urgency or frequency issues before or after. I was told that it could happen but it never did. I do have loose bowels as a result of all of this though. That started just a few days into the IMRT treatments and has stayed that way ever since. I was fatigued as a result of the IMRT but the seed implants didn't really have any effect as far as I could tell. Best wishes on your journey.
Posted 3/18/2011 3:20 PM (GMT 0)
Hi Nutmeg,

I did not have the brachytherapy as you have elected. I just wanted to give you another resource for asking a question. I am a member of this site as well and another called prostate pointers and they have a group dedicated to BT.

Here is the blurb and url.

SeedPods

A mailing list for those interested in brachytherapy (radioactive
seed implants) as a treatment for prostate cancer. To subscribe,
go to:

http://www.prostatepointers.org/mailman/listinfo/seedpods

Don

Posted 3/18/2011 4:34 PM (GMT 0)
Netmeg,
Most of what you are experiencing is normal. My symptoms lasted about 4 weeks. Avoid all caffine and alcohol and take metamucil for your bowels. If you take a sleeping plill like Ambian it will slow your getting up at night. The symptoms you are describing are normal and last 4 to 8 weeks depending on the patient.
JohnT
Posted 3/18/2011 5:55 PM (GMT 0)
I had some rectal discomfort during the 'hot days' (10-25), but that cleared up. Actually, the only thing that is an issue now is if I cut it too close to getting to the bathroom. I sometimes have a bit of leakage. But as John T says, that is rarely an issue if one avoids caffine and alcohol. Of course, I avoid neither.
I would, and do, recommend brachy to anyone who is a good candidate.
Posted 3/18/2011 6:07 PM (GMT 0)
Thanks gentlemen. I think some of my anxiety stems from reading so many website and blog reports from guys who say they had "no side effects after brachytherapy".

GOP - could you tell me what you mean by "hot days"?

JohnT - I'm drinking water, herbal teas, and gatorade. Definitely no caffeine or alcohol. And I've just started Metamucil (half dose) with fingers crossed. Couple years ago I tried it and only got cramps and more bloating.

Don - I just joined that SeedPod list. Thanks.

Fulltlt - I envy you being urination problem free. Sounds great! And frankly, I could live with the bowel movement issues, except that the "tight and bloated" feeling 24/7 is about driving me nuts.

RayPat - all that info is *really* good to know. You're one of the first guys who has had similar issues to mine. And that "slow stream with frequent urination" explanation sure makes sense.

Jack - sounds like the "temp implant" procedure is a bit more traumatic. I had "black and blue balls" for about a week, but never any pain or problems sitting.

Thanks guys. Any other comments *gratefully* accepted!

Tom M.
Posted 3/18/2011 6:17 PM (GMT 0)
Tom, sorry to be a little delayed in responding.

As others have said, your symptoms are in the "normal" range, but IMHO probably toward the worse end.  Part of this may be that you had Pallidium which tend to have a little more severity of SE's than the Iodine.  The good news with Pallidium however is that the half life is 17 days vs. 60 days for Iodine.  So...the radiation in your body should dissipate more quickly and the symptoms should pass sooner.

I had the Iodine and my SE's were probably on the mild side of normal.  I had some frequency and urgency for about 3 months that was easily controlled with Flomax.  Nothing else...not even discomfort for more than one day. Though I did cheat with some alcohol and spicy food once and paid the price!  As JT says, lay off the alcohol, caffeine and anything spicy for about 3 months. 

Tudpock (Jim)

Posted 3/18/2011 6:26 PM (GMT 0)
Thanks Jim. I kinda figured the Palladium has more "heft" than the Iodine, with the different half lives. My doctors say that any side effects are mostly completely gone at the end of the fourth half life, which leaves me another 3 weeks or so.

Tom
Posted 3/18/2011 8:28 PM (GMT 0)
Tom, just relax and know things will get better. It may take more than 3 more weeks to feel "normal" since everybody reacts differently. I will say though that when my frequent urination symptoms did improve it was a noticeable improvement within a 10 day period. Like I said you may have to retrain your bladder/mind. After peeing so often for so long I found myself doing "protective peeing" every time I had to leave the house for more than an hour. Good luck and keep us posted on how you're doing.
Posted 3/19/2011 2:13 AM (GMT 0)
Tom, Don't know much about seeds I had open surgery but I noted that this is your first post and wanted to welcome you to healing well. As you can see the board is very active and you will find great support from all the guys here. Hang in there buddy you will get better over a short period of time.

Cajun jeff
Posted 3/19/2011 2:53 AM (GMT 0)
Welcome as well, I am surgery and srt guy, wanted seeds, but couldnt at the time. looks like you have been getting loads of good tips/advice. good luck to you. and hope you stay in toouch with us.

david in sc
Posted 3/19/2011 2:39 PM (GMT 0)
Tom,

In my case with HDR there are two procedures rather than the one that you had. In each, 15 catheters are inserted into the prostate and SVs through which the radiation wire passes. Thus there is twice as much physical intervention as with the permananet seeds so I had two weeks of troublesome sitting rather than one.

Also, the radiation that you have over about 60 days was delivered to me in a total of 30 minutes. Thus there is significant and immediate radiation to the area which does more initial killing and injuring (think shock and awe) versus the slow and gradual radiation of the seeds.

Both systems are very reliable and effective each with their own comparative pros and cons.

It sounds like you are on track and doing well.
Posted 3/19/2011 2:53 PM (GMT 0)
Nutmeg,
I have to be honest with you, even after going through all of this, I still don't know all of the names of the proceedures. I don't know HDR from anything else. I had a mapping biopsy which told the doctor A) the extent of the disease, and B) where the best placement for the seeds would be. I have the seeds that are permanent which I think means they are low dose. At any rate, they emit the most radiation between days 10 and 25. That is when one is most likely to have the uncomfortable side effects. It worked out pretty close to that time frame for me. Like I said, rectal discomfort was my biggest complaint. I used a rubber 'life saver' for a while. No issues now..yours will clear up as well.

Post Edited (GOP) : 3/19/2011 8:56:40 AM (GMT-6)

Posted 3/19/2011 3:05 PM (GMT 0)
Thanks again gentlemen. I wish there were a "Side Effects You May Experience, and How to Deal With Them" pamphlet available. Hearing from guys who know the details themselves is a *great* help.

One of the frustrating aspects of calling the doctor about these things is as follows:

Call the number. Get recording "Thank you for calling Surgery Associates (or whatever), where your health is of utmost importance to us. Did you know you can reach us on the Web at www.surgeriesassoc.com? That's w w w dot surgeriesassoc dot c o m. You can find information about our staff and doctors, procedures, and lots of useful information.

"We are happy to announce our association with Dr. Bumptious Q. Bangwhistle, a specialist in veeblefetzer replacement. You can find more information about him on our website at w w w dot surgeriesassoc dot com forward slash new forward slash surgeons forward slash recent."

"Our menu has changed. Please listen to all the choices before entering a number."

[five seconds of stupid music]

"If you are a doctor or other health professional, please press 6"
"If you wish to schedule an appointment, please press 17".
"If you wish to re-schedule or change a previously scheduled appointment, please press "70"
"If you wish to discuss billing, please press 36".
"If you wish a statement mailed to you, please press 84"
"If this is a medical emergency, please hang up and dial 911"
"If you wish to speak to an advice nurse, please hold the line"

<so you hold the line and finally get "The advice nurse is currently busy. Please leave a detailed message, your account number, the date and location of your surgery, the billing reference, and your telephone number, and the nurse will return your call as soon as possible">

Thus ... online forums are a heck of a lot more "comforting"!

By the way, if anyone knows of such a thing as the pamphlet I wondered about earlier, please let me know. The usual "You may experience some urinary and bowel changes" isn't much help for the guy with the specific worries!

Tom M.

Post Edited (NutmegCT) : 3/19/2011 9:10:57 AM (GMT-6)

Posted 3/19/2011 7:11 PM (GMT 0)
Nutmeg, I too am not aware of any such pamphlet on all the P0SSIBLE side effects of the Brachytherapy. You have done the right thing by checking with the guys here on this web site who have gone through the procedure themselves. I had my Brachy last May 26th and was able to drive home from Illinois to Colorado just one day later with no problems at all. Kinda felt like sitting on a golf ball for part of the 1,000 mile trip but no BIG deal. Never did have any incontinence problems and am now able to pee even better than before I went through the procedure. Did experience some bowel issues but they were very minor. And a few months after the procedure, it felt like someone put a red hot poker up the butt which provided a terrific itch about an inch or two up the rear end. Told my contact at the Brachy facility and received an Rx for "Anucort-HC 25mg sup G&W" This was a suppository for rectal insertion and it did work wonders for me. I suppose there are really a lot of POSSIBLE side effects but most are pretty minor and I was apparently very fortunate not to encounter but a couple of the very minor ones. Immediately after the procedure, I was informed that I would not leave the facility until I could pee a certain amount into a plastic flask. With just a tiny bit of coaxing, I was able to do that and never did have to have a catheter poked up old peewee.
I am now in the middle of some nasty allergies or a very bad cold and it seems most cold remedies/medicines have a caution not to take them if we have an enlarged prostate. Called my Uro Doc about this and he said that is correct and to watch close on what is taken to relieve those cold symptoms. He recommended a nasal spray which would not be as risky as other remedies which could possibly require catheterization .
I am extremely careful about that. Good luck to you NutmegCT and keep us posted on your Brachy side effects.
Posted 3/20/2011 1:16 AM (GMT 0)
Ya know... As a surgery guy, I still have not had an honest answer from the brachy guys.  I had no urinary or rectal problems, but I do have forever erectile problems.  I still have not heard  any brachy guy tell me that he has never had  erectile problems now or 5 or 10 years down the line.  I know that we all tread carefully around this subject, but it does not serve any of us well to hide the truth.  I have found a solution for my erectile problems with bimix injections.  It works, but I am  always concerned about the future..

I guess what I really want to know is...do brachy guys still get a raqing erection any time they want to???  Or is it a problem that they still deal with but will not share with the rest of us?.

If I thought I could still get erections, I would have ignored my doctors and chosen brachytherapy rather than surgery.   Something to think about??

Posted 3/20/2011 2:41 AM (GMT 0)
Lifeguyd, I haven't seen any evidence of any brachy guys trying to hide the truth and I'm not sure what led you to that conclusion.  But I will be happy to answer your question.  I'm sure since you have been around this forum long enough to read the stats that indicate fewer sexual problems and better sexual satisfaction with brachy patients than with surgery patients.

However, I'll just speak for myself and not refer to anyone else.  I resumed sexual activity 2 weeks after my brachytherapy procedure and my sex life has been totally "normal", i.e. same as pre-procedure since then.  To be specific that means great with zero erectile problems. I am now 2 1/2 years post procedure.  Will it be the same after 5 or 10 years....who knows...I sure hope so.  I look forward to being around to let you know.

Tudpock (Jim)

Posted 3/20/2011 3:05 AM (GMT 0)
I can't speak for any seeding side effects, as I had surgery first, then SRT, but 16 months after SRT ended for me, still zero ED issues, nothing has changed even with all the radiation I received. Have been told, that the ED effect from any radiation can take a couple of years or more to develop, I hope not.

David
Posted 3/20/2011 7:42 PM (GMT 0)
As a quick follow up to the ED question ... if you're six weeks after brachytherapy, on two Flomax a day, and still have slow flow urination and urethra narrowing ... is there any danger of problems in ejaculation? Seems a powerful ejaculation going into a very narrow urethra could be problematic (to say the least).

Tom
Posted 3/20/2011 8:11 PM (GMT 0)
lifeguyd,
I had both Brachy and IMRT about two years ago. The only problem I had with ED was while I was on HT; I could get it up but had no interest.
I have since had no problem with ED and can get it up at any time without any meds.
I'm not implying that there is no ED with Brachy, just that the probabilities are better.
Tom,
The amount of ejaculate you have after seeding is reduced quite a bit, so I don't think you will have this type of issue.
JT
Posted 3/20/2011 8:38 PM (GMT 0)
Lifeguard,

I chose Brachy because 1)I believed (and still do) that the results would be at least as good as surgery, 2) I know quite a few guys who had absolutely horrible results with surgery, and 3) because it looked like brachy would give me a better chance of maintaining a decent sex life. From what I read, if I did get ed from brachy,  I had a better chance of responding to drugs.

While I have always responded to 'stimulation', I noticed before and after treatment that I am not waking up with an erection. I read that may be an early sign of ed, and I was concerned even though, as I said, I never had a problem in a 'performance' situation. Still, my doctor told me to let him know immediately if I had any concerns in this area. I told him about what I believe is a lack of nocturnal erections, and he prescribed viagra. Holy cow. I cut the 100's in half and still feel like I'm 25. I hope that this response continues. My insurance will cover 6 pills per month, but I have fould that the ones from All Day Chemist work just as well at a fraction of the cost. That's my honest answer: believe it or not.

Oh, and as to the ejaculation issue, in my case there is none, or very little, but without a 'viusal', I wouldn't even know that. Sensation is truly more intense than before, but you probably won't believe that either.

Post Edited (GOP) : 3/20/2011 2:45:08 PM (GMT-6)

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